Luciano: Fighting opioid overdoses at the Peoria library

For decades as a librarian, Roberta Koscielski would fret about rowdy teens and overdue books.

Now she worries about heroin overdoses. The last one occurred at the Downtown branch Wednesday morning.

As libraries nationally face a plague of on-site overdoses, the Peoria Public Library’s deputy director is on the forefront of education about the epidemic, which has prompted each local branch to keep a heroin-antidote kit. It's been an eye-opening experience for Koscielski, in her fourth decade with the library.

"You don't learn this in library school," Koscielski, 58, said hours after this week's overdose. "I didn't know anything about this stuff. I go to bed early every night. But it's happening here."

Last month, the New York Times detailed an increase of vigilance for possible drug overdoses at libraries across the country. From small towns to big cities, more and more libraries are going so far as to stock naloxone, commonly known as Narcan, to administer to people to reverse the effects of an overdose of heroin or other opioids.

"The opioid epidemic is reshaping America, including at the local library, where librarians are considering whether to carry naloxone to battle overdoses," the paper stated. "At a time when the public is debating arming teachers, it is another example of an unlikely group being enlisted to fight a national crisis."

Indeed, it's been an unlikely development for Koscielski, who in 1982 earned a master's degree in library and information science, then joined the Peoria library two years later. At the time, the biggest disruption tended to be rambunctious teens using the library for socializing rather than researching.

"Times have changed," she says.

Libraries, of course, are open to the public, meaning all sorts of people might wander in. Though the homeless often have used libraries as daytime shelters, occasional erratic behavior rarely involved a life-or-death dilemma. Opioids have changed that risk, at libraries and everywhere else. In 2016, 64,000 died nationally of opioid abuse; already this year, Peoria has been hit with as many as 12 opioid deaths.

By 2015, Koscielski had become aware of the trend of libraries becoming a place of refuge for opioid users.

"It's all over," she says. "If it's not happening at your library, it's happening at a fast-food place. It's getting closer to (all) people. It's not just a homeless person. It's happening in people's homes."

In Peoria, the opiate of choice is often heroin.

"Peoria is kind of a source city," Koscielski says. "People come from out of town to get it."

In early 2016, Koscielski decided to bring in experts to educate library staff about the growing problem. With attendance voluntary, sign-ups were scant as the June date neared. But days before the meeting, a man came to a Downtown reference desk, slurred briefly and hit the floor. A staffer called 911, and emergency personnel managed to revive the visitor with naloxone. Days after that first known heroin overdose at the library, staffers packed the opioid-education meeting.

Over the ensuing months, the library became more involved in opioid awareness. Joining the Mayor's Community Coalition Against Heroin, the library has linked its website to opioid resources. Koscielski has brought in Sam Quinones, author of “Dreamland,” an acclaimed book about the nation’s heroin epidemic.

Recently, Koscielski and a Peoria colleague were slated to give an opioid-awareness presentation at a conference of the Illinois Library Association. They expected maybe a dozen attendees. But when Koscielski walked into the meeting room, the place was packed with scores of librarians — not just standing-room only, but also sitting-room only, with many guests jammed cross-legged on the floor, eager to get brought up to speed regarding the scourge.

"I liken this to the AIDS epidemic," she says. "You're losing a generation of people."

With opioids, at least, there's an emergency stopgap with naloxone, which neutralizes opiates' effects, often quickly bringing the user back from the brink of death. The Downtown library has multiple kits, supplied by the Human Service Center, and each of four branches is equipped with one. Overdoses have hit only the Downtown library, which had its third Wednesday morning. A security guard making rounds popped into a public restroom, where a man was unresponsive on the floor. A quick call to 911 brought emergency responders, who saved a life with naloxone.

With overdoses so far at the library, the kits haven't been used, in part because 911 calls bring help in a flash. Furthermore, the library's naloxone comes with syringes, not in the oft-typical nasal-spray version. Though Koscielski and others have practiced by injecting oranges, some might be skittish about their first human injection.

More concerning, she says, is the possible reaction of a suddenly recovered opioid addict, possibly irate that their high has been killed by naloxone.

"Are they going to be violent?" Koscielski asks. "Are they going to be OK?"

Still, she is glad to have the kits for emergency purposes, though she realizes their availability might encourage visitors to get high at the library, with naloxone as a safety net.

"Who knows if in the back of their mind they think, 'Somebody will call for help'?" Koscielski says. "But that's a big risk for them. How often can we go looking in restrooms?"

Even amid just three overdoses, she acknowledges that an atmosphere of naloxone kits and opioid vigilance might put off some book-minded library guests. However, she emphasizes that a security guard is on hand, as the library seeks to serve all guests during challenging times and trends.

"People should feel safe here," Koscielski says.

In light of the ongoing opioid epidemic, local police will join recovery experts, politicians and others for the Peoria Recovery Project. The public-education event will run from 9 a.m. to 4 p.m. April 21 at the Peoria Civic Center.

PHIL LUCIANO is a Journal Star columnist. He can be reached at pluciano@pjstar.com, facebook.com/philluciano and (309) 686-3155. Follow him on Twitter.com/LucianoPhil.

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